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目的探讨外周血自然杀伤(NK)细胞及其亚群在新生儿细菌性肺炎中的变化及临床意义。方法 44例细菌性肺炎新生儿根据住院天数分为两组,即住院≤10 d组,住院>10 d组;根据入院时白细胞(WBC)的数量分为轻度感染组和重度感染组,轻度感染即5.0×10~9/L20.0×10~9/L。采用流式细胞术测定44例新生儿细菌性肺炎及22例正常新生儿总NK细胞及其亚群在外周血总淋巴细胞中所占的百分率。结果细菌性肺炎患儿外周血总NK细胞及其亚群CD3~-CD56~-CD16~(bright)的百分率明显低于对照组新生儿;住院≤10 d组患儿外周血CD3~-CD56~-CD16~(bright)亚群占淋巴细胞的百分率明显低于正常对照组新生儿,而总NK细胞及CD3~-CD56~(dim)CD16~(bright)、CD3~-CD56~(bright) CD16~(-/dim)亚群无明显差异。住院>10 d组患儿外周血总NK细胞及CD3~-CD56~-CD16~(bright)亚群占淋巴细胞的百分率明显低于正常对照组;住院>10 d组外周血总NK细胞及CD3~-CD56~-CD16~(bright)、CD3~-CD56~(dim)CD16~(bright)、CD3~-CD56~(bright)CD16~(-/dim)各亚群占外周血总淋巴细胞的百分率显著低于住院≤10 d组患儿;重度感染的患儿总NK细胞数及其亚群CD3~-CD56~-CD16~(bright)、CD3~-CD56~(dim)CD16~(bright)、CD3~-CD56~(bright)CD16~(-/dim)占外周血淋巴细胞的百分率明显低于轻度感染组;细菌性肺炎患儿外周血中NK细胞CD3~-CD56~(bright)CD16~(-/dim)和CD3~-CD56~(dim)CD16~(bright)亚群占总NK细胞的百分率明显高于正常对照组,而外周血CD3~-CD56~-CD16~(bright)亚群占总NK细胞的百分率明显低于正常对照组。结论新生儿细菌性肺炎患儿病情越严重,住院时间越长,总的NK细胞数量及其各亚群占NK细胞的百分率越低。
Objective To investigate the changes and clinical significance of natural killer (NK) cells and their subpopulations in bacterial pneumonia in newborns. Methods Forty-four neonates with bacterial pneumonia were divided into two groups according to the number of days of hospitalization: hospitalization ≤ 10 days and hospitalization> 10 days. According to the number of white blood cells (WBC) at admission, they were divided into mild infection group and severe infection group. Degree infection was 5.0 × 10 ~ 9 / L 20.0 × 10 ~ 9 / L. Flow cytometry was used to determine the percentage of total NK cells in 44 neonates with bacterial pneumonia and 22 normal neonates in total peripheral blood lymphocytes. Results The percentage of CD3 ~ -CD56 ~ -CD16 ~ (bright) in peripheral blood of children with bacterial pneumonia was significantly lower than that of the control group. The CD3 ~ -CD56 ~ The percentage of CD16 ~ (bright) subpopulation in lymphocytes was significantly lower than that in normal control group, while the ratio of total NK cells and CD3 ~ -CD56 ~ (bright) CD16 ~ (bright) CD3 ~ CD56 bright CD16 ~ (- / dim) subgroup no significant difference. The percentage of total NK cells and CD3 ~ -CD56 ~ -CD16 ~ (bright) subpopulations in peripheral blood of patients in the hospital> 10 d group was significantly lower than that of the normal control group. The total NK cells and CD3 CD56 ~ -CD16 ~ (bright), CD3 ~ -CD56 ~ (dim) CD16 ~ (bright), CD3 ~ -CD56 ~ (bright) CD16 ~ The percentage of total NK cells and CD3 ~ -CD56 ~ -CD16 ~ (bright), CD3 ~ -CD56 ~ (dim) CD16 ~ (bright) , CD3 ~ -CD56 ~ (bright) CD16 ~ (- / dim) accounted for the percentage of peripheral blood lymphocytes was significantly lower than the mild infection group; children with bacterial pneumonia in peripheral blood CD3 ~ CD56 bright CD16 The percentage of ~ (- / dim) and CD3 ~ -CD56 ~ (dim) CD16 ~ (bright) subpopulation in total NK cells was significantly higher than that in normal control group, while CD3 ~ -CD56 ~ -CD16 ~ The percentage of total NK cells in the group was significantly lower than that of the normal control group. Conclusions The more serious the disease is, the longer the hospitalization time is in children with bacterial pneumonia. The total number of NK cells and the percentage of NK cells in each subgroup are lower.